Medicare expands affordable obesity drug coverage for seniors

Popular obesity drugs will become far more affordable from Wednesday for several seniors under the government’s new Bridge demonstration program.

Eligible beneficiaries will pay $50 monthly for blockbuster weight-loss medicines from Novo Nordisk and Eli Lilly, making the treatments affordable for millions of Americans for the first time. The program has been extended through 2027.

While Medicare already covers GLP-1 drugs for diseases like Type 2 diabetes, the new rules expand coverage to weight-loss medications.

Who qualifies
The new benefit is not automatic.

To qualify, Medicare beneficiaries must be enrolled in Part D, have obesity and meet the program’s eligibility requirements, obtain a prescription from their healthcare provider, and receive prior authorization from the Centers for Medicare & Medicaid Services (CMS).

However, people already receiving Medicare coverage for GLP-1 drugs to treat Type 2 diabetes, cardiovascular risk reduction, or sleep apnea are not eligible for the Bridge program.

Awareness remains low
Despite the landmark expansion, awareness is limited. A recent survey of more than 2,100 adults aged 65 and older found that 82% were unaware that Medicare was about to cover obesity drugs. Experts warn that many eligible patients may delay starting treatment simply because they do not know the benefit exists.

The rollout is quiet
Instead of launching a major advertising campaign, Medicare has focused on preparing doctors, pharmacies, and healthcare providers before promoting the benefit to the public. 

Officials say broader outreach will begin after the launch, while experts expect physicians and pharmacists to play a key role in informing eligible patients.

Nearly 40% of Americans aged 65 and older have obesity, and more than 56 million people are enrolled in Medicare Part D.